Many remained unaccounted for as emergency services scrambled to find victims trapped under collapsed buildings in L'Aquila, which bore the brunt of the quake, and officials warned that the toll would rise.

Prime Minister Silvio Berlusconi declared a state of emergency and cancelled a trip to Russia so he could go to L'Aquila, capital of Abruzzo region, about 100 kilometres (60 miles) northeast of Rome.The quake struck just after 3:30 am (0130 GMT) and lasted about 30 seconds, bringing down many of the town's Renaissance and Baroque buildings.

Roofs caved in on sleeping inhabitants and boulders fell off mountain slopes blocking many roads. At least five children were among the dead in L'Aquila, according to police quoted by ANSA news agency.

The quake measured magnitude 6.2, according to the Italian geophysical institute.

The epicentre was just outside L'Aquila and heavy damage was inflicted up to 30 kilometres (20 miles) away in all directions, emergency services told AFP.

Sirens blared across L'Aquila as rescue workers with dogs raced to find people in the rubble. Thousands of the 60,000 residents fled into the streets as more than a dozen aftershocks rattled the town.

Some even left L'Aquila by foot with belongings in suitcases leaving behind the historic buildings with badly cracked walls and debris strewn across the streets.

Rescue workers pulled several people alive out of one four-storey building and said could hear a women's cries in the rubble. They planned to try to lift the roof with a giant crane.

Maria Francesco said: "It was the apocalypse, our house collapsed. It's destroyed, and there's nothing left to recover."

Doctors treated people in the open air outside L'Aquila's main hospital as only one operating room was functioning.

L'Aquila suffered the biggest toll. Other dead were reported in the surrounding towns and villages of Castelnuovo, Poggio Picenze, Tormintarte, Fossa, Totani and Villa Sant'Angelo, said police quoted by ANSA.

Pope Benedict XVI was praying for the victims, the Vatican said. But Guido Bertolaso, head of Italy's public safety department, warned the toll would rise.

"It's an event that will mobilise the nation for many weeks," he said, adding that at least 10,000 homes or buildings had been damaged in the quake.

Residents of the region told how the quake terrorised them.

Matthew Peacock, who lives with his wife and child in the Umbrian town of Amelia, near the main quake zone, told Britain's Sky television: "It felt like the house was being shaken from the rooftop -- my bed was banging against the wall and you could hear this creaking.

"I rushed across the hallway to my son, who's five, grabbed him and stood underneath the doorway. The shaking went on for 20 seconds or so."

He went on: "The earth really felt like jelly underneath. Dogs outside were making an incredible racket."

Barry Raven, a Briton living in Monte San Marino, 60 miles (100km) northeast of L'Aquila, said his house shook for about 30 seconds.

"When you felt it you were thinking 'Is this the beginning or is this the end?" he told Sky News.

The epicentre of the quake, which was also felt in Rome, was some five kilometres (three miles) south of L'Aquila, public safety officials said. The quake was only five kilometers below the surface.

Some 15,000 people suffered a power outage and the L'Aquila to Rome highway was closed.

The quake came about five hours after a 4.6-magnitude tremor shook the Ravenna district in Emilia-Romagna region, which was felt over a wide area, notably in the Marche region on the Adriatic coast, officials said.

A powerful earthquake in the region claimed 13 lives in 1997 and damaged or destroyed priceless cultural heritage.

Italy is criss-crossed by two fault lines, making it one of Europe's most quake-vulnerable regions, with some 20 million people at risk.

An October 2002 quake killed 30 people including 27 pupils and their teacher who were crushed under their schoolhouse in the tiny medieval village of San Giuliano di Puglia.

On November 23, 1980, a violent quake struck the southern region of Irpiona near Naples, killing 2,570, injuring 8,850 and displacing 30,000.